Novel Input for Designing Patient-Tailored Pulmonary Rehabilitation: Telemonitoring Physical Activity as a Vital Sign—SMARTREAB Study

Figures

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  Figure 1. (a) Patient receiving instructions on how to use the SMARTREAB equipment: an Android smartphone with an accelerometer (to be used at waist level using a belt with an inside pocket), connected by Bluetooth to a portable oximeter with finger or ear sensor. During telemonitoring patients have access to the smartphone screen information indicating % of transcutaneous oxygen saturation, bpm of heart rate and metabolic equivalent of task (MET) of physical activity. (b) Together patient and physiotherapist analyze retrospective telemonitoring data integrating important input for the design of the patient-tailored pulmonary rehabilitation. (The patients and healthcare professional shown consented to be photographed and such images to be used for research publication purposes).

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  Figure 2. Example of SMARTREAB telemonitoring transcutaneous oxygen saturation (SpO2), heart rate (HR) and physical activity intensity (MET) on a single daytime period of a chronic respiratory patient. This example shows 38.5% of telemonitoring time with oxygen desaturation with daily physical activity below 2.42 METs. The increased heart rate and decreased SpO2 between 15:30 and 18:30 corresponds to performing household chores such as vacuuming, mopping, dusting and tidying up.

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  Figure 3. Enrollment flow diagram.

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  Figure 4. Telemonitoring time: (a) spent on activities below 2 METs by self-reported IPAQ level of physical activity; (b) spent on activities below 2 METs by self-reported IPAQ level of physical activity per chronic respiratory disease; (c) spent on activities between 2 and 3 METs by self-reported IPAQ level of physical activity; (d) spent on activities between 2 and 3 METs by self-reported IPAQ level of physical activity per chronic respiratory disease; (e) spent on activities above 3 METs by self-reported IPAQ level of physical activity; (f) spent on activities above 3 METs by self-reported IPAQ level of physical activity per chronic respiratory disease.

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  Figure 5. SMARTREAB rationale to operationalize single-patient PADL telemonitoring data as an input to set individually-tailored pulmonary rehabilitation goals. All patients, including cases A and B described, were the center of identification and characterization of targeted desaturation tasks, and thereby actively involved on specific goal-setting and commitment to intervention success.